title: Masked trial of topical anesthesia for retinopathy of prematurity eye examinations.
abstract: OBJECTIVE
  To observe the effect of a topical anesthetic on pain and corneal clarity in premature infants undergoing eye examinations for retinopathy of prematurity (ROP).
  
  
  METHODS
  ROP examinations were performed on premature infants who were randomized to receive either proparacaine 0.5% or an artificial tear solution in the right eye. All infants received an artificial tear solution in the left eye. Assessment of discomfort was performed by use of the Premature Infant Pain Profile (PIPP) during examination of the right eye, with a painful event defined as a PIPP score≥11. The left eye was then examined and a comparison of corneal clarity was made between the 2 eyes.
  
  
  RESULTS
  A total of 39 examinations were performed on 34 infants: artificial tear solution was administered 17 times and topical proparacaine anesthetic 22 times. The mean PIPP score for those receiving artificial tears was 10.4 compared with 8.8 for the anesthetic group (p=0.17). Of the examinations without anesthetic, 65% were painful, compared with 27% with anesthetic (p=0.04). No effect on corneal clarity was observed in any examination.
  
  
  CONCLUSIONS
  The use of a topical anesthetic appears to marginally decrease pain and has no adverse effect on subjectively assessed corneal clarity during examination of premature infants for ROP.
authors.affiliation: Department of Ophthalmology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama 35233, USA. mcogen@uab.edu
authors.forename: Martin S
authors.initials: MS
authors.lastname: Cogen
authors.forename: Jack S
authors.initials: JS
authors.lastname: Parker
authors.forename: Todd E
authors.initials: TE
authors.lastname: Sleep
authors.forename: Frederick J
authors.initials: FJ
authors.lastname: Elsas
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Metz
authors.forename: Gerald
authors.initials: G
authors.lastname: McGwin
mesh_terms: D000287:Administration, Topical; D000779:Anesthetics, Local / Q000008:administration & dosage*; D004311:Double-Blind Method; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D009883:Ophthalmic Solutions / Q000008:administration & dosage*; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D010808:Physical Examination; D011430:Propoxycaine / Q000008:administration & dosage*; D012178:Retinopathy of Prematurity / Q000175:diagnosis*
chemical_list: D000779:Anesthetics, Local; D009883:Ophthalmic Solutions; C005717:proxymetacaine; D011430:Propoxycaine